Adaptive deep brain stimulation timed to gait phase improves walking in Parkinson's disease.

Gait dysfunction in Parkinson's disease (PD) is a major source of disability and is often resistant to traditional deep brain stimulation (DBS). Here, we report a novel neuromodulation paradigm, gait-phase-synchronized adaptive DBS (aDBS), that dynamically modulates stimulation amplitude during contralateral leg swing. In five individuals with PD, we identified personalized neural biomarkers of gait phase from cortical and pallidal field potentials and embedded them into a chronically implanted bidirectional neurostimulator.

Assessing side-effect bother, burden, and tolerability: A qualitative study exploring the content validity of the Functional Assessment of Cancer Therapy - Item GP5.

Introduction: Patient-reported measures of overall side effect burden such as the Functional Assessment of Cancer Therapy - item GP5 (GP5) can be used to assess the tolerability of cancer treatments. The single-item GP5, which reads "I am bothered by side effects of treatment," has served as an endpoint in clinical trials. The objectives of this qualitative study were to explore how participants with medullary thyroid cancer (MTC) conceptualize side effect bother, burden, and tolerability and to generate evidence to support the GP5 as a fit-for-purpose measure of patient-reported tolerability in the treatment of MTC and to establish which response options constitute "high side effect burden.

Exploring the layers of fatigue in Parkinson's Disease: A comprehensive analysis of its prevalence and contributing factors.

Background: Fatigue is a prevalent yet under-recognized non-motor symptom (NMS) of Parkinson's disease (PD), significantly impacting patients' quality of life. Despite its clinical importance, the relationship between fatigue and other motor and non-motor symptoms remains poorly understood. Its frequent co-occurrence with other NMS further complicates both diagnosis and management, often leading to underdiagnosis and suboptimal treatment.

The symptoms evolution of long COVID‑19 (SE-LC19): a new patient-reported content valid instrument.

Background: The field of long COVID research is rapidly evolving, however, tools to assess and monitor symptoms and recovery of the disease are limited. The objective of the present study was to develop a new patient-reported outcomes instrument, the Symptoms Evolution of Long COVID‑19 (SE-LC19), and establish its content validity.

Methods: The 40-item SE-LC19 instrument was developed based on patient-relevant empirical evidence from scientific literature and clinical guidelines that reported symptoms specific to long COVID.

Sleep benefits perceptual but not movement-based learning of locomotor sequences.

Practicing complex locomotor skills, such as those involving a step sequence engages distinct perceptual and motor mechanisms that support the recall of learning under new conditions (i.e., skill transfer).

Visuospatial cognition predicts performance on an obstructed vision obstacle walking task in older adults.

Walking performance and cognitive function demonstrate strong associations in older adults, with both declining with advancing age. Walking requires the use of cognitive resources, particularly in complex environments like stepping over obstacles. A commonly implemented approach for measuring the cognitive control of walking is a dual-task walking assessment, in which walking is combined with a second task.

Thematic analysis to explore patients' experiences with long COVID-19: a conceptual model of symptoms and impacts on daily lives.

Objectives: There is limited qualitative research on patients' experiences with long COVID-19, and how specific symptoms impact their daily lives. The study aimed to understand patients' lived experiences of long COVID-19 and to develop a conceptual model representing the symptoms and their impact on overall quality of life.

Setting: Qualitative study consisting of a comprehensive literature review, and in-depth clinician and patient semistructured interviews.

Reduced corticospinal drive and inflexible temporal adaptation during visually guided walking in older adults.

Corticospinal drive during walking is reduced in older adults compared with young adults, but it is not clear how this decrease might compromise one's ability to adjust stepping, particularly during visuomotor adaptation. We hypothesize that age-related changes in corticospinal drive could predict differences in older adults' step length and step time adjustments in response to visual perturbations compared with younger adults. Healthy young ( = 21; age 18-33 yr) and older adults ( = 20; age 68-80 yr) were tested with a treadmill task, incorporating visual feedback of the foot position and stepping targets in real-time.

Hummingbird ingestion of low-concentration ethanol within artificial nectar.

Both frugivores and nectarivores are potentially exposed to dietary ethanol produced by fermentative yeasts which metabolize sugars. Some nectarivorous mammals exhibit a preference for low-concentration ethanol solutions compared to controls of comparable caloric content, but behavioural responses to ethanol by nectar-feeding birds are unknown. We investigated dietary preference by Anna's Hummingbirds () for ethanol-enhanced sucrose solutions.

Cortico-Subthalamic Field Potentials Support Classification of the Natural Gait Cycle in Parkinson's Disease and Reveal Individualized Spectral Signatures.

The ability of humans to coordinate stereotyped, alternating movements between the two legs during bipedal walking is a complex motor behavior that requires precisely timed activities across multiple nodes of the supraspinal network. Understanding of the neural network dynamics that underlie natural walking in humans is limited. We investigated cortical and subthalamic neural activities during overground walking and evaluated spectral biomarkers to decode the gait cycle in three patients with Parkinson's disease without gait disturbances.

Corticospinal drive is associated with temporal walking adaptation in both healthy young and older adults.

Healthy aging is associated with reduced corticospinal drive to leg muscles during walking. Older adults also exhibit slower or reduced gait adaptation compared to young adults. The objective of this study was to determine age-related changes in the contribution of corticospinal drive to ankle muscles during walking adaptation.

Visuomotor errors drive step length and step time adaptation during 'virtual' split-belt walking: the effects of reinforcement feedback.

Precise foot placement is dependent on changes in spatial and temporal coordination between two legs in response to a perturbation during walking. Here, we used a 'virtual' split-belt adaptation task to examine the effects of reinforcement (reward and punishment) feedback about foot placement on the changes in error, step length and step time asymmetry. Twenty-seven healthy adults (20 ± 2.

Age differences in adaptation of medial-lateral gait parameters during split-belt treadmill walking.

The split-belt treadmill has been used to examine the adaptation of spatial and temporal gait parameters. Historically, similar studies have focused on anterior-posterior (AP) spatiotemporal gait parameters because this paradigm is primarily a perturbation in the AP direction, but it is important to understand whether and how medial-lateral (ML) control adapts in this scenario. The ML control of balance must be actively controlled and adapted in different walking environments.

Disentangling the energetic costs of step time asymmetry and step length asymmetry in human walking.

The metabolic cost of walking in healthy individuals increases with spatiotemporal gait asymmetries. Pathological gait, such as post-stroke, often has asymmetry in step length and step time which may contribute to an increased energy cost. But paradoxically, enforcing step length symmetry does not reduce metabolic cost of post-stroke walking.

Neural Control of Human Locomotor Adaptation: Lessons about Changes with Aging.

Walking patterns are adaptable in response to different environmental demands, which requires neural input from spinal and supraspinal structures. With an increase in age, there are changes in walking adaptation and in the neural control of locomotion, but the age-related changes in the neural control of locomotor adaptation is unclear. The purpose of this narrative review is to establish a framework where the age-related changes of neural control of human locomotor adaptation can be understood in terms of reactive feedback and predictive feedforward control driven by sensory feedback during locomotion.

Contributions of spatial and temporal control of step length symmetry in the transfer of locomotor adaptation from a motorized to a non-motorized split-belt treadmill.

Walking requires control of where and when to step for stable interlimb coordination. Motorized split-belt treadmills which constrain each leg to move at different speeds lead to adaptive changes to limb coordination that result in after-effects (e.g.

Teaching during a pandemic: Using high-impact writing assignments to balance rigor, engagement, flexibility, and workload.

The COVID-19 pandemic has created new challenges for instructors who seek high-impact educational practices that can be facilitated online without creating excessive burdens with technology, grading, or enforcement of honor codes. These practices must also account for the possibility that some students may need to join courses asynchronously and have limited or unreliable connectivity. Of the American Association of Colleges and University's list of 11 high-impact educational practices, writing-intensive courses may be the easiest for science faculty to adopt during these difficult times.

Brain Network Oscillations During Gait in Parkinson's Disease.

Human bipedal walking is a complex motor task that requires supraspinal control for balance and flexible coordination of timing and scaling of many muscles in different environment. Gait impairments are a hallmark of Parkinson's disease (PD), reflecting dysfunction of cortico-basal ganglia-brainstem circuits. Recent studies using implanted electrodes and surface electroencephalography have demonstrated gait-related brain oscillations in the basal ganglia and cerebral cortex.

Step time asymmetry but not step length asymmetry is adapted to optimize energy cost of split-belt treadmill walking.

Key Points: The relationship between spatiotemporal gait asymmetry and walking energetics is currently under debate. The split-belt treadmill paradigm has been used to study adaptation of spatiotemporal gait parameters in relation to energetics, but it remains unclear why people reduce asymmetry in step lengths, but prefer asymmetry in step times. In this study we characterized the effects of step time asymmetry and step length asymmetry on energy cost during steady-state walking on a split-belt treadmill at increasing speed-differences.

Increased intramuscular coherence is associated with temporal gait symmetry during split-belt locomotor adaptation.

When walking on a split-belt treadmill where one belt moves faster than the other, the nervous system consistently attempts to maintain symmetry between legs, quantified as deviation from double support time or step length symmetry. It is known that the cerebellum plays a critical role in locomotor adaptation. Less is known about the role of corticospinal drive in maintaining this type of proprioceptive-driven locomotor adaptation.

Prevention of lipid loss from hair by surface and internal modification.

Surfactants during routine washing have a tremendous effect on lipid loss from hair. This study aims to understand the loss of lipids from hair upon contact with surfactants and develop a way to prevent the lipid loss. The change in lipid levels depends on the relative hydrophobicity of the lipid.

Corticospinal control of normal and visually guided gait in healthy older and younger adults.

We investigated age-related differences in corticospinal control of muscle activity during normal and visually guided (VG) walking. Young (n = 15, 22.1 ± 1.

Dramatic response to cyclin D-dependent kinase 4/6 inhibitor in refractory poorly differentiated neuroendocrine carcinoma of the breast.

Neuroendocrine tumors are a rare subset of breast carcinomas. Commonly, platinum-based doublet is used as a systemic treatment option for high-grade neuroendocrine carcinomas from lung, gastrointestinal, and genitourinary origins. In comparison to other breast cancers, neuroendocrine carcinomas have unique genomic features and different treatment strategies.

Increased central common drive to ankle plantar flexor and dorsiflexor muscles during visually guided gait.

When we walk in a challenging environment, we use visual information to modify our gait and place our feet carefully on the ground. Here, we explored how central common drive to ankle muscles changes in relation to visually guided foot placement. Sixteen healthy adults aged 23 ± 5 years participated in the study.

Performance of a visuomotor walking task in an augmented reality training setting.

Visual cues can be used to train walking patterns. Here, we studied the performance and learning capacities of healthy subjects executing a high-precision visuomotor walking task, in an augmented reality training set-up. A beamer was used to project visual stepping targets on the walking surface of an instrumented treadmill.